Provider Demographics
NPI:1588625982
Name:KANE, NORMAN (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:
Last Name:KANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9834 GENESEE AVE
Mailing Address - Street 2:STE 228
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1215
Mailing Address - Country:US
Mailing Address - Phone:858-455-9942
Mailing Address - Fax:858-455-6473
Practice Address - Street 1:9834 GENESEE AVE
Practice Address - Street 2:STE 228
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1215
Practice Address - Country:US
Practice Address - Phone:858-455-9942
Practice Address - Fax:858-455-6473
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33041207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP8020OtherMEDICARE RAILROAD GROUP #
CAZZZ72841ZMedicaid
CA92056B01OtherCHAMPUS
CAA27019Medicare UPIN
CA92056B01OtherCHAMPUS
CAWA33041AMedicare ID - Type UnspecifiedMCARE PROV NUM